The present invention relates to a surgical operation system and method for percutaneously securing a cavity as a working space for a surgical operation in the body by using a cavity securing tool.
Recently, increasing numbers of operations in cavities in body tissues using endoscopes have been performed. The merit of such an operation is that a low invasive operation can be performed because a treatment is made with an approach to a cavity in the body through a small incision as compared with so-called open surgery in which a treatment is made with an approach to a target treatment site after a large incision is made in the tissue. However, one of the problems in endoscopic operations is that it is difficult to secure a good site of operation in the body.
For example, percutaneous lumbar discectomy is generally performed as follows. A median incision is made in the back of the patient to expose the back muscle. The back muscle is incised, and the incision in the back muscle is spread open by using a pushing element, thereby exposing the lumbar vertebrae. Part of the lamina of vertebral arch is removed to expose the yellow ligament having the nerve root. The yellow ligament is then incised, and the dura mater located therebelow is shifted to one side. The evagination portion of the hernia located on the rear side of the dura mater is removed. In a general conventional operation in which a median incision is made in the back of the patient, and a site of operation is exposed by using a pushing element, a lumbago occurs after the operation because a large incision is made in the dorsolumbar muscle, the dorsolumbar is separated from the bones, or the dorsolumbar muscle is pushed for a long period of time or with a strong force. In addition, pushing may cause unrecoverable damage to the back muscle.
Under the circumstances, as disclosed in U.S. Pat. No. 5,439,464, a technique of performing a back operation has been proposed. According to this technique, a plurality of cannulas are inserted from the back of the patient to positions near the spine. Physiological saline is then injected to a portion near the spine through one of the canulas to secure a working space with the pressure of the physiological saline. A hard mirror and a treatment tool are introduced through the remaining cannulas. After this process, an endoscopic operation is performed.
According to a general technique based on a so-called open surgery, an incision is made in the back to expose the back muscle, and the incision in the back muscle is spread open by a pushing element, thereby exposing the lumbar vertebrae. In this operation, pushing causes great damage to the back muscle. This may cause unrecoverable damage to the back muscle. In addition, an incision itself may cause great damage to the back muscle and the like.
In the technique of using a plurality of cannulas as in U.S. Pat. No. 5,439,464, damage to the back muscle by an incision and pushing is relatively small, but a sufficient visual field and a sufficient working space cannot be obtained.